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Playing Cognitive Games For Older Adults With Insomnia (PLAY)

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Know the risks and potential benefits of clinical studies and talk to your health care provider before participating. Read our disclaimer for details. Identifier: NCT04282642
Recruitment Status : Recruiting
First Posted : February 25, 2020
Last Update Posted : April 28, 2021
American Academy of Sleep Medicine Foundation
Information provided by (Responsible Party):
Ashley Curtis, University of Missouri-Columbia

Brief Summary:
The purpose of this research is to look at the effects of computerized cognitive training on sleep, mental abilities (cognition), and other aspects of daytime functioning, such as mood, and arousal

Condition or disease Intervention/treatment Phase
Insomnia Behavioral: Cognitive Training Behavioral: WLC (Waitlist Control) Not Applicable

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 60 participants
Allocation: Randomized
Intervention Model: Crossover Assignment
Intervention Model Description: Participants will be randomly assigned to either the cognitive training or waitlist control(WLC). In both conditions, they will receive the intervention, but the waitlist control will receive this later. Both groups will complete 6 weeks of the cognitive training game either immediately after 1 week baseline (cognitive training group) or after the week 8 assessments (WLC).
Masking: Single (Outcomes Assessor)
Primary Purpose: Treatment
Official Title: Effects of Computerized Cognitive Brain Training on Sleep, Arousal, and Daytime Functioning in Older Adults With Insomnia
Actual Study Start Date : March 1, 2020
Estimated Primary Completion Date : February 28, 2022
Estimated Study Completion Date : February 28, 2022

Arm Intervention/treatment
Experimental: Cognitive Training
Computerized Cognitive Training
Behavioral: Cognitive Training
Participants (n=20) provided game console with cognitive training games and activities.

Experimental: WLC
Waitlist Control
Behavioral: WLC (Waitlist Control)
Participants (n=20) will receive the cognitive training intervention later, following week 8 assessments.

Primary Outcome Measures :
  1. Subjective Behavioral Sleep- Electronic Daily Sleep Diaries [ Time Frame: Up to 15 weeks ]
    Electronic Daily Sleep Diaries. Online diaries completed each morning (~5 mins) during 1 wk assessment period and 6 weeks of intervention. Diaries measure sleep onset latency, wake time after sleep onset, total sleep time, and sleep quality.

  2. Subjective Behavioral Sleep- Insomnia Severity Index [ Time Frame: Up to 15 weeks. ]
    Brief self-report measure of current perception of insomnia symptom severity, distress and daytime impairment. Commonly used in insomnia treatment outcome research.

  3. Objective Physiological Sleep [ Time Frame: Up to 15 weeks ]
    Single night PSG measured sleep stages.

Secondary Outcome Measures :
  1. Game-related experience [ Time Frame: Up to 6 weeks ]
    During the intervention phase for each group, participants will complete "gaming diary" measuring session duration, games played.

  2. Objective Behavioral Sleep - Actigraphy [ Time Frame: Up to 15 weeks ]
    Actiwatch 2 (Philips Respironics) is a watch-like device that monitors light and motor activity. Device is worn 24 hours a day for 7 days at each assessment, and during 6 weeks of intervention. Data analyzed by proprietary software using 30s epochs. Validated algorithm will be used to obtain sleep onset latency, wake time after sleep onset.

  3. Circadian Rhythm - Morningness-Eveningness Questionnaire [ Time Frame: Up to 15 weeks ]
    19-item questionnaire that assesses preference for morning, afternoon, and evening activities. Total score reflects degree of "morningness" or "eveningness" type.

  4. Physiological Arousal- Heart Rate Variability [ Time Frame: Up to 15 weeks ]
    Holter monitor assessed 5 min ECG recordings both at rest and during sleep (with PSG).Time index variables: SDNN (standard deviation of normal to normal heartbeat intervals). Spectral index variables: High frequency (0.15-0.4 Hz), low frequency (0.04-0.15 Hz), very low frequency (below 0.04 Hz).

  5. Subjective Arousal-Global Cognitive Arousal-Perceived Stress Scale [ Time Frame: Up to 15 weeks ]
    Perceived Stress Scale is a self-report measure of how life situations are perceived as stressful. The scale consists of 15 items corresponding to everyday situation and participants are asked to rate on a likert scale from 0 (never) to 4 (very often) how often they felt or thought a specific way. Higher scores correspond to higher perceived stress.

  6. Objective Cognition- NIH Toolbox Cognitive Battery [ Time Frame: Up to 15 weeks ]
    20-min computerized battery completed in single sitting on iPad.Domains tested include processing speed and attention, visuospatial ability and memory, verbal learning and memory, and executive functioning and working memory.

  7. Subjective Cognitive Self-Efficacy- Cognitive Failures Questionnaire [ Time Frame: Up to 15 weeks ]
    A 25-item scale measuring subjective cognition. Participants rate on a scale of 0 (never) to 4 (very often) how often they experience cognitive mistakes and errors in daily tasks.

  8. Mood- Beck Depression Inventory (II) [ Time Frame: Up to 15 weeks ]
    21-item inventory that asks respondents to rate on a scale of 0 (no depressive feelings) to 3 (most depressive feelings) their feelings towards various aspects of daily living/situations. Higher total scores indicate worse depressive symptoms.

  9. Alcohol Use- Alcohol Use Disorder Test [ Time Frame: Baseline ]
    10-item questionnaire that assess the frequency of alcohol use and problems associated with alcohol use over the past year.

  10. Mood- State-Trait Anxiety Inventory [ Time Frame: Up to 15 weeks ]
    Inventory that asks respondents to rate how true 20 self-descriptive statements (e.g., I feel calm) are on a 4-point scale (1 = not at all, 4 = very much so). Typically, respondents are asked to rate statements according to how they generally feel (trait-anxiety scale) and how they feel in the current moment (state-anxiety scale). Total scores range from 20 to 80, with higher scores indicating greater maladjustment.

  11. Subjective Arousal- Pre-sleep Arousal Scale [ Time Frame: Up to 15 weeks ]
    Pre-sleep Arousal Scale is a 16-item self-report questionnaire comprising both cognitive and somatic manifestations of arousal.

  12. Subjective Arousal- Arousal Predisposition Scale [ Time Frame: Up to 15 weeks ]
    Arousal Predisposition Scale is a 12-item inventory that has been designed to measure the degree to which an individual experiences arousal. Higher scores indicate greater predisposition to arousal.

Information from the National Library of Medicine

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Ages Eligible for Study:   60 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   Yes

Inclusion Criteria:

  • 60+ yrs of age.
  • No neurological or psychiatric illness, dementia, or loss of consciousness > 5 mins.
  • Nongamers (i.e. <1 hour of video/cognitive training games per week over last 2 years)
  • Proficient in English (reading and writing).
  • Meet clinical diagnosis for Insomnia.


  • Insomnia complaints for 6+ months.
  • Complaints occur despite adequate opportunity and circumstances for sleep.
  • Consist of 1+ of the following: difficulty falling asleep, staying asleep, or waking up too early
  • Daytime dysfunction (mood, cognitive, social, occupational) due to insomnia.

Exclusion Criteria:.

  • Unable to provide informed consent.
  • Unable to undergo randomization.
  • Cognitive impairments (i.e. mild cognitive impairment, dementia)
  • Other sleep disorder (i.e., sleep apnea, Periodic Limb Movement Disorder)
  • Severe untreated psychiatric comorbidity that renders randomization unethical
  • Using psychotropic or other medications (e.g., beta-blockers) that alter sleep
  • Uncorrected visual/auditory impairments
  • Participation in nonpharmacological treatment for sleep/fatigue/mood outside the current study.

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT04282642

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Contact: Kenda Eberhardt 573-884-3293

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United States, Missouri
University of Missouri Recruiting
Columbia, Missouri, United States, 65201
Contact: Ashley Curtis, PhD         
Principal Investigator: Ashley Curtis, PhD         
Sponsors and Collaborators
University of Missouri-Columbia
American Academy of Sleep Medicine Foundation
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Principal Investigator: Ashley Curtis, PhD University of Missouri- School of Medicine
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Responsible Party: Ashley Curtis, Assistant Professor, University of Missouri-Columbia Identifier: NCT04282642    
Other Study ID Numbers: 2018341
First Posted: February 25, 2020    Key Record Dates
Last Update Posted: April 28, 2021
Last Verified: April 2021

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Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No
Keywords provided by Ashley Curtis, University of Missouri-Columbia:
Cognitive training
Older Adults
Additional relevant MeSH terms:
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Sleep Initiation and Maintenance Disorders
Sleep Disorders, Intrinsic
Sleep Wake Disorders
Nervous System Diseases
Mental Disorders